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Basu: An Indian facial may have fixed what U.S. medical specialists couldn't

When I called this week to cancel an appointment I’d waited months to get in for, the receptionist at University of Iowa’s dermatology clinic kindly reminded me that if I changed my mind and rescheduled, it would take months more.

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OPINION

Basu: An Indian facial may have fixed what U.S. medical specialists couldn't

Two drugs were used to treat the same skin condition, one from the U.S., one from India. The American one comes with a long list of possible side effects and cost 100 times as much. But the Indian one worked better(Photo: Rekha Basu/The Reguster)

When I called this week to cancel an appointment I’d waited months for at the University of Iowa’s dermatology clinic, the receptionist kindly reminded me that if I changed my mind, it would take months more to reschedule. But after a year of shelling out hundreds of dollars on doctors, labs and medicines to clear up the rough patches on my elbows that had gotten me nowhere, I'd come up with another approach.

Actually, a beautician giving me a facial in an Indian beauty parlor had come up with it during my recent annual visit to India. Seeing my elbows, the woman dispatched a pedicurist to the drugstore next door to get me an over-the-counter ointment she said would bring signs of improvement in a week. And it did.

I bring this up not because my skin problems are of much consequence. On the contrary. If a beauty parlor employee can recognize symptoms and suggest a treatment that works after two doctors, a biopsy and several medications couldn't, it suggests a larger problem with our profit-obsessed medical care system and pharmaceutical industry.

I was prescribed a corticosteroid costing me $49.21 for a 60 gram tube (despite my prescription drug plan). But, true to the warnings in the accompanying literature, it seemed to only make the condition worse. More sobering, the literature warned, among other things, of possible trouble breathing or talking, hives, fever, tightness in the chest, confusion, "breath that smells like fruit," mood changes, passing out, and "moon face."

Moon face?

I discontinued the treatment before any of that could occur, and turned to an argan oil concoction bought from an herbal doctor in Morocco over Christmas. That helped a bit, but I was still looking ahead to the University of Iowa clinic appointment.Then I got the facial and the Betnovate-N (betamethasone valerate) made by GlaxoSmithKline, with no doctor or prescription. A 20-gram tube cost less than 50 cents and the box only warns "systemic absorption on prolonged use and sensitivity to the ingredient Neomycin may occur occasionally."

Betnovate-N isn’t available in the U.S. I learned from some visiting Italian friends that it used to be available in Italy until about three years ago, and they had relied on it for successful treatment of skin problems. They suspected the inexpensive cream was undercutting sales of more expensive products from other companies. So they were wildly excited to discover they could still get it in India.

Lyndsay Meyer, a spokeswoman for the U.S. Food and Drug Administration couldn’t tell me why it's not licensed for use here, or even if the United Kingdom-based company has applied for a U.S. license. (My calls to various company spokespeople went unreturned.) It's possible there was a problem with the cream, but if so, wouldn't that have showed up in my online searches?

What Meyer could tell me was that, “In most circumstances, it is illegal for individuals to import drugs into the U.S. for personal use.” Those could get snatched at the border except possibly in the case of a three-month supply for personal use, and not for a serious condition. Exceptions can also be made if it's for a serious condition and no effective treatment is available in the U.S. But the medicine would have to have no "known significant health risk." Unlike, say, the steroid cream I was prescribed here?

Asked if some drugs are excluded to enable U.S. companies to maintain a monopoly, an FDA official who declined to give her name cited a prohibition against a drug company offering substantially the same drug that another company has released within about 10 months.

School districts in Johnson County are reacting to a new Iowa law allowing schools to obtain prescriptions for Epinephrine auto-injectors, such as EpiPens, and to keep supplies of them on hand.(Photo: For the Press-Citizen)

Spending on legal drugs in America totaled $457 billion in 2015. Prices rose 12.6 percent between 2013 and 2014. The Affordable Care Act, which the new president and congressional Republicans are working to dismantle, required health insurers to cover prescription drugs. But it didn't reduce drug prices. Drug companies are free to profiteer as much as they want, as evidenced by last year's Epipen fiasco. Mylan bought the patent to the injectable drug, which counteracts potentially fatal allergic reactions, and hiked the price more than 500 percent in 10 years, to $609.

According to the nonprofit news organization TruthOut the drug industry lobby group PhRMA spent $238 million on lobbying in 2015, and spends up to $50.7 million a year on campaign contributions to lawmakers.

I couldn't find out why Betnovate-N isn't available here. But it bothers me that the average American consumer would have no way to even know of its existence, since not everyone goes to India for facials. What other drugs are out there that might give relief from persistent conditions at low cost? Though I'm personally grateful for the find, something is out of whack when it falls to random luck and an Indian beautician to deliver the relief that American doctors and medicines couldn't.